Rural hospitals struggle to stay open, adapt to changes

OSCEOLA, Mo. (AP) — After 45 years of providing health care in rural Missouri, Sac-Osage Hospital is being sold piece by piece.

Ceiling tiles are going for 25 cents, the room doors for an average of less than $4 each, the patient beds for $250 apiece. Soon, the remnants of the hospital that long symbolized the lifeblood of Osceola, population 923, will be torn to the ground.

Sac-Osage is one of a growing number of rural U.S. hospitals closing their doors, citing a complex combination of changing demographics, medical practices, management decisions and federal policies that have put more financial pressure on facilities that sometimes average only a few in-patients a day.

"Money just kept drying up," said Chris Smiley, a former operating-room nurse who was the last chief executive of Sac-Osage and is now overseeing its liquidation.

Standing near the doorway of a room stripped of its cabinets and sinks, Smiley stared down a hospital hallway where a man was carting off $1 boxes of unwanted items — pencils, plastic X-ray covers, a fish bowl, even a fly swatter.